Glucose Metabolism and Coronary Heart Disease in Patients With Normal Glucose Tolerance

• Published in: JAMA : the journal of the American Medical Association 2004-04, Vol.291 (15), p.1857-1863
• Main Authors: Sasso, Ferdinando C, Carbonara, Ornella, Nasti, Rodolfo, Campana, Biagio, Marfella, Raffaele, Torella, Michele, Nappi, Giannantonio, Torella, Roberto, Cozzolino, Domenico
• Format: Article
• Language: English
• Subjects: Arteriosclerosis - blood; Biological and medical sciences; Blood Glucose - metabolism; Cardiology. Vascular system; Cardiovascular disease; Coronary Angiography; Coronary Disease - blood; Coronary Disease - diagnostic imaging; Coronary Disease - epidemiology; Coronary heart disease; Cross-Sectional Studies; Diabetes; General aspects; Glucose; Glucose Tolerance Test; Glycated Hemoglobin A - metabolism; Heart; Humans; Insulin; Male; Medical sciences; Metabolism; Middle Aged; Patients; Risk Factors
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.291.15.1857

CONTEXT Several investigations as well as prospective studies have shown a significant correlation between glucose metabolism and atherosclerosis in patients without diabetes, but differences in parameters of glucose metabolism among the various degrees of coronary disease in such patients have not been specifically evaluated. OBJECTIVE To investigate glucose metabolism in patients with normal glucose tolerance (NGT) and coronary heart disease (CHD). DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of 234 men (mean [SD] age, 56.2 [6.1] years) with NGT and suspected CHD who were admitted from January 1 through June 30, 2001, to an academic medical center in Italy for coronary angiography. MAIN OUTCOME MEASURES Correlation of glucose metabolic factors and extent of atherosclerosis determined by coronary angiography. Factors included levels of fasting and postload glucose and insulin, glycosylated hemoglobin (HbA1c), and lipids, as well as insulin resistance measured by homeostasis model assessment (HOMA-IR). RESULTS Patients were divided into 4 groups based on coronary angiography: no significant stenosis (n = 42), 1-vessel disease (n = 72), 2-vessel disease (n = 64), and 3-vessel disease (n = 56). Simple correlation analysis showed that the factors correlated with the extent of atherosclerosis were levels of postload glucose (r = 0.667), HbA1c (r = 0.561), postload insulin (r = 0.221), and fasting insulin (r = 0.297), as well as HOMA-IR (r = 0.278) (P